| NPI | 1780126532 |
|---|---|
| Former Name | JENNIFER SHORT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.024164) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY 254266) |
| Enumeration Date | 2016-11-10 |
| Last Update Date | 2024-10-22 |